OBJECTIVES: Antiplatelet therapies are recommended to reduce the risk of recurrent stroke in patients with non-cardioembolic ischemic stroke (IS) or transient ischemic attack (TIA); however, increased risk for bleeding may limit the use of currently approved agents. Real-world data on effectiveness and safety of antiplatelet regimens are lacking. This study evaluated outpatient antiplatelet treatment patterns for secondary stroke prevention (SSP) after first hospitalization for IS/TIA among UK adults without atrial fibrillation (AF). METHODS: This retrospective observational study utilized data from the UK Clinical Practice Research Datalink linked with Hospital Episode Statistics data from 1/1/2011–6/30/2019. Patients with AF diagnosis or oral anticoagulant use before index hospitalization were excluded. Outcomes included type and duration of treatments received for SSP and treatment patterns, including use of single antiplatelet therapy (SAPT) and dual antiplatelet therapy (DAPT). RESULTS: Of the 9,568 patients in this analysis, mean age was 72.1 years and 47.4% were female; 85.3% were treated with antiplatelet or anticoagulant therapy and 14.7% were untreated within 90 days of hospital discharge. Among 8,162 treated patients, 97.9% received antiplatelets, 2.0% received anticoagulants, and 0.1% received both; the most commonly used antiplatelet therapies were clopidogrel (5,975) or aspirin (1,336) SAPT and clopidogrel+aspirin DAPT (470). The median duration of any antiplatelet therapy was 293, 232, and 300 days for patients who initiated clopidogrel, aspirin, and DAPT, respectively. Of patients initiating DAPT, 62.3% switched to SAPT (83% clopidogrel, 17% aspirin; median time to switch=56 days). Two years after initial hospitalization for IS/TIA, 39.9%, 44.1%, and 38.7% of patients no longer took antiplatelet treatment among those previously receiving clopidogrel, aspirin, and DAPT, respectively. CONCLUSIONS: Many patients at risk of secondary stroke were not receiving or had discontinued antiplatelet therapy. Further analyses are needed to explore reasons for early antiplatelet discontinuation and evaluate outcomes of patients in this study.